ACORD 139 MI (2004/07) – Michigan Automobile Insurance Placement Facility Supplement to ACORD Application.

Application for Commercial, Public Automobiles and Corporately Owned Vehicles

Use this form as a supplement when applying for insurance through the Michigan Automobile Insurance Placement Facility. This supplement must be used in conjunction with:

• ACORD 125 – Commercial Insurance Application
• ACORD 127 – Business Auto Section
• ACORD 132 – Truckers/Motor Carriers Section
• ACORD 163 – Commercial Auto Driver Information Schedule
• ACORD 129 – Vehicle Schedule
• ACORD 45 – Additional Interest
• ACORD 194 – Truckers/Motor Carrier Supplement